Health Partners Management Group (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG is currently submitting a proposal on a contract with the Federal Government for multiple Credentialing Specialist positions. Work can be done remotely.

Should HPMG win the contract you would be a W-2 employee for HPMG and NOT a government employee.

SUMMARY: Provides clerical/administrative support. Schedules appointments in Composite Health Care Systems (CHCS/AHLTA) or MHS GENESIS for primary care, specialty and subspecialty medical care. In addition to scheduling requested appointments, this position will call patients to schedule, reschedule, and/or cancel appointments as needed, to include appointments for consult/referral specialty care within the MTF. Serves as a medical records technician to process and maintain inpatient, outpatient or ambulatory procedure unit medical records. Required to compile or extract medical records data to ensure compliance with regulatory requirements.

MANDATORY KNOWLEDGE AND SKILLS:

• A fully qualified typist (computer keyboard) with a minimum of 50 WPM is required.
• General medical ethics, telephone etiquette, and excellent communication and customer service skills.
• English language, correct grammar, spelling, punctuation, capitalization, and format to prepare and edit written correspondence, reports, and transcribed material.
• Ability to communicate effectively, both orally and in writing
• General office administrative and clerical skills to perform receptionist duties and answer telephones.
• Ability to use standard office equipment, such as computers, typewriters, copiers, fax machines, telephone systems and office automations systems, to perform a substantial range of medical record maintenance support.
• General knowledge of Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards; Accreditation Association for Ambulatory Health Care (AAAHC) for complete, prompt, and accurate health records.

UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:

• Armed Forces Health Longitudinal Technology Application (AHLTA)
• Composite Health Care Systems (CHCS) and/or MHS GENESIS
• Defense Enrollment Eligibility Reporting System (DEERS);
• Military Filing System – by sponsor social security number, terminal digit order, color-coded and blocked filing system.
  • Contents of a military medical record, layout, sections, family member prefix designation, forms used in a MTF, and the medical record tracking procedures.
  
  

PERFORMANCE OUTCOMES:

• Designated DHA and AFMS agent to gather credentialing information, perform PSV of healthcare professionals’ credentials, affiliation and work history verifications, sanction checks, and conduct databank queries. This supports the credentialing and privileging processes at DHA MTFs and ARC medical units.
• Completes written PSV documentation capturing the required components to document the PSV IAW DHA PM 6025.13, vol 4, directed by the COR and all regulatory guidelines.
• Reviews credentialing applications, conduct follow-up in a timely manner to obtain missing credentials/information, conduct verifications, create provider credentialing records within CCQAS and maintain the CCQAS record. Records must be current at all times.
• Contacts medical office staff, educational institutions, employers, licensing and certifying agencies, to obtain and complete the verification of credentials.
• Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt.
• Updates the appropriate screens within CCQAS to capture the credential and PSV of the credential. Converts documentation to a PDF format, scans, appropriately names and uploads the documentation to the provider’s electronic credentials file.
• Completes credentialing tasks routed to the DHACCVO for action and appropriately updates the provider’s electronic credentials file IAW DHA PM 6025.13, vol 4, and regulatory guidelines.
• Identifies and reports potential “red flags” to the requestor and submits required credentials verification summaries, completes verification tasks within CCQAS and scans, appropriately names and uploads required documentation to CCQAS.
• Audits provider credentials application and credentials file for compliance with requirements outlined in DHA PM 6025.13, vol 4, DAFI 44-119 and regulatory guidelines.
• Transfers provider credentials files to MTF credentials office or training office as appropriate. Closes out and inactivates electronic JCCQAS records when appropriate.
• Responds to queries/request for information and resolves originating request or routes the request to the appropriate individual for resolution.
• Performs credentialing tasks in support of the processes managed by the senior credentialing specialists and in response to MTFs requests.